Skip to main content

BRIEF RESEARCH REPORT article

Front. Neurol.
Sec. Epilepsy
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1524799
This article is part of the Research Topic Pharmaco-Resistance in Epileptic Conditions View all 3 articles

Decanoic acid-enriched Ketogenic Diet in Refractory Epilepsy

Provisionally accepted
Hui Jin Shin Hui Jin Shin 1Seonae Ryu Seonae Ryu 1NaRae Lee NaRae Lee 1Eunjoo Lee Eunjoo Lee 1Ara Ko Ara Ko 1Hoon-Chul Kang Hoon-Chul Kang 1Joon Soo Lee Joon Soo Lee 1Se Hee Kim Se Hee Kim 1*Heung Dong Kim Heung Dong Kim 1,2*
  • 1 College of Medicine, Yonsei University, Seoul, Republic of Korea
  • 2 Kangbuk Samsung Hospital, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Objective: To assess the anti-seizure efficacy and safety of a C10-enriched medium-chain triglyceride (MCT) ketogenic diet (KD) compared with the classic KD in pediatric patients with refractory epilepsy.Methods: This 16-week, open-label, randomized, controlled, crossover pilot study was conducted at Severance Children's Hospital, Seoul, South Korea, between August 2022 and September 2023. Fifteen pediatric patients with refractory epilepsy were enrolled and received classic KD and C10-enriched KD for 8 weeks each. The study compared seizure reduction rate, tolerability, and safety of the two diets.Results: Fifteen patients were enrolled. Patients were divided into 2 groups depending on the type of KD initiated. Ten patients completed the trial. Initial treatment with the C10-enriched KD resulted in seizure reduction in all five patients, with two becoming seizure-free. Classic KD was effective in two out of five patients. Upon crossover, those initially on C10-enriched KD maintained their seizure reduction, while patients initially on the classic KD showed additional seizure reduction when switched to C10-enriched KD. Adverse effects included transient hypoglycemia, metabolic acidosis, hypercalciuria, and gastrointestinal symptoms, all of which were manageable.The C10-enriched KD demonstrated comparable efficacy and tolerability to the classic KD, offering a promising option for patients with refractory epilepsy who do not respond adequately to the classic KD alone. This study, the first to directly compare a C10-enriched KD with a classic KD, highlights the potential synergistic effects of decanoic acid.

    Keywords: Decanoic acid, Ketogenic Diet, Epilepsy, Refractory, seizure

    Received: 08 Nov 2024; Accepted: 10 Jan 2025.

    Copyright: © 2025 Shin, Ryu, Lee, Lee, Ko, Kang, Lee, Kim and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Se Hee Kim, College of Medicine, Yonsei University, Seoul, Republic of Korea
    Heung Dong Kim, College of Medicine, Yonsei University, Seoul, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.